【摘要】 目的:观察全身麻醉经尿道前列腺电切术后老年患者认知功能障碍(POCD)的发病率,研究血浆S-100β蛋白和稳态氧化氮产物浓度与POCD的关系。方法:选择40例ASAⅠ-Ⅱ级年龄68-82岁患者,择期进行经尿道前列腺电切术。在术前1 d,术后4 d和6周进行神经心理学测试,一个或多个认知功能缺陷被确定为认知功能障碍。并在术前和术后不同的时间点测定血浆S-100β蛋白和稳态氧化氮产物浓度。结果:术后4 d,有16例患者发生POCD(40%),术后6周有20例患者发生POCD(50%)。与没有认知功能障碍的患者比较,术后4 d发生POCD患者围术期各时间点血浆稳态氧化氮产物浓度明显增强(P<0.05),而血清S-100β蛋白浓度没有差异。结论:经尿道前列腺电切术老年患者术后POCD发生率为40%-50%,POCD的发生与血浆稳态氧化氮产物浓度相关,与血浆S-100β蛋白浓度无关。更多还原

【Abstract】 Objective: To determine the incidence of postoperative cognitive dysfunction(POCD) after transurethral resection of the postate(TURP) under general anesthesia in old patients and to examine its association with plasma concentrations of S-100 protein and stable nitric oxide(NO) products.Methods: Neuropsychological tests were performed on 40 ASA physical status I-II patients aged 68-82 years weighing 47-65 kg undergoing general anesthesia at the day before surgery,at 4 d and in the 6th week postoperation.Patient spouses(n=15) were studied as controls.Cognitive dysfunction was defined when the subject was deficient in one or more cognitive domain(s).Serial measurements of serum concentrations of S-100 protein and plasma concentrations of stable NO products(nitrate/nitrite,NOx) were performed perioperatively.Results: Four days after surgery,new cognitive deficits were found in 16(40%) patients.Six weeks postoperatively,new cognitive deficits were found in 20(50%) patients.Compared with the "non-deficit" group,patients who demonstrated a new cognitive deficit at 4 d had the highest plasma NOx(P<0.05).Serum S-100 protein concentrations were similar between the two groups.Conclusion: Preoperative(and postoperative) plasma concentrations of stable NO products are associated with early POCD.The plasma concentrations of stable NO products represents a potential biochemical predictor of POCD.更多还原